By Gibao Brima

In a bid to help in the reduction of the stigma, discrimination, human rights violations on HIV victims, tuberculosis vulnerable and key populations in our various local communities nationwide, a national nongovernmental organization called Women In Crisis Movement under the dynamic leadership of Rev. Mrs. Juliana Konteh has organized five days training and sensitization for healthcare workers, community healthcare workers and other health service providers, from Kono, east and west of Freetown on topics centered on humans rights, tuberculosis, HIV, vulnerable and key populations among others under the New Funding Method 3 Grant in Quarter II, 2024. The training took place at Swiss Hotel in Lumley west end of Freetown from 15th to 18th January 2024.

In her opening statement and overview of Women In Crisis Movement and Global Fund operations, Rev. Mrs. Juliana Konteh underscored that on 1st July 2021 her Movement signed a contract with the Ministry of Health through Integrated Health Project Administration Unit (IHPAU) being the principal recipient and Women In Crisis a sub recipient to implement a three year activities under the Global Fund New Funding Method 3 (NFM3) for the period June 2021 to June 2024.

WICM intervention areas she said include condom and lubricant programme, legal literacy (know your right) HIV/tuberculosis related legal services, stigma and discrimination, reduction on HIV/tuberculosis, gender discrimination, harmful gender norms and violence against girls and women in all their diversity, human rights and medical ethics related to HIV and HIV/TB for healthcare providers, sensitization of lawmakers and law enforcement agents, community mobilization and advocacy on HIV/TB i.e (face-to-face) community programmes.

She said these interventions take place in WICM operational areas in western area ie east and west of Freetown and Kono district in the eastern province. She further dilated that the training will focus on human rights and medical ethics related to HIV and HIV/Tuberculosis for healthcare providers.

She said the importance behind this training is to let the healthcare workers know the type and category of women we refer to as key populations and also the important role they play toward the success of the whole project. She further admonished all participants to listen attentively and have frank discussions so that they will be able to take away good information from the five days training which will help them as healthcare workers in their various communities they live.

Dilating on the goal and objectives of the training, Mr. Ibrahim Saidu, head of programme and policy at Women In Crisis Movement said the training is geared toward the prevention of HIV/AIDS, provide treatment care and support to reduce new HIV infection, AIDS related mortality and removing human rights related barriers to HIV services through the elimination of HIV related stigma and discrimination.

The objectives, Mr. Saidu said is to contribute to strengthening HIV combination prevention among key and vulnerable populations. To enable healthcare providers that support to adequately cater for the unique healthcare needs of those at greater risk of HIV most especially key affected populations, improve access to and utilization of HIV testing services (HTS) among key populations, promote improved health seeking behaviours among key populations, support the scaling up of HIV prevention, care and support and treatment programmes for all high risk groups nationwide.

In his teaching in order to have understanding about key population or who are key populations, Mr. Kemoh Mansaray from National HIV/AIDS Secretariat underscores that key populations according to National SOP for key population include the following groups: People who use drugs (PWIDs), people who inject drugs (PWIDs), female sex workers (FSWs), men sex men (MSM), Trans genders (TGs) and other vulnerable groups such as street living and working children (OVCs), adolescent and young women, fishermen and fishing communities, plantation workers, mobile population ie long distance truck drivers and females who engage in anal sex ie heterosexual practices.

He said it’s important to reduce HIV prevalence among key population having a deep understanding of the HIV. Vulnerabilities of key population is very critical he said if the needs of these population are to be adequately addressed. Key populations are at the risk of acquiring and transmitting HIV.

They are essential and accelerating, sustain or curbing HIV epidemic.

Giving an overview of HIV status in Sierra Leone, Mr. Mansaray said currently the national prevalence is as 1.7% in 2019 in as much the prevalence he said is low but has nearly doubled over the past two decades. The prevalence increased from 0.9% in 2019 to 1.7% in 2020. The HIV prevalence in women 15-49 years is doubled than in men at 2.2% against 1.1% respectively. Similarly, the prevalence is three times higher 1.5% among adolescent girls and young women aged 15-24 years compare to adolescent boys and young men of the same age 0.5%.

Dilating further, he said the new infection age between15-19 is at the highest therefore testing of pregnant women will help to reduce HIV.

15 to 24 years need keen attention since they are the key starters. HIV status per district he said, are as follows:

Western area urban 2.0%, Western area rural 3.4%, Port Loko 2.5%, Moyamba 1.8%, Koinadugu 2.1%, Bo 1.6%, Bombali 2.0%, Kono 1.3%, Kailahun 0.6%, Falaba 0.8%, Karene 0.9%, Tonkolili 1.2%, Bonthe 0.7%, Kambia 1.0%, Pujehun 0.9% and Kenema 1.3%.

In his teaching on human rights and its violations and its laws, stigma, causes and effects Mr. Amara Lebbie Human Right Technical Adviser at National AIDS Secretariat underscores that Global Fund is the highest donor in Sierra Leone having a social contract with Sierra Leone government through the Ministry of Health in the tune of 153 million United States dollars since 1st July 2021.

However, Mr. Lebbie said the donor has found out that the money given out to fight malaria, TB and above all HIV there is a breaking barriers ie human right aspect needs to be addressed and that is why this training and sensitization for you all health workers here today will help you to reduce HIV related stigma and discrimination, it will help to transform healthcare workers on human rights and ethics related to HIV, Programmes to sensitize lawmakers and law enforcement agents, programme to provide legal literacy (know your rights), programme to provide HIV legal services and programme to reduce discrimination against women and girls in the context of HIV. All what we need, Mr. Lebbie reiterated is total intervention and commitment since all of us are not safe therefore the relationship between HIV counselors and the patients need to be cordial. Patient’s right charter is very important as long as he/she walks voluntarily into the hospital for treatment, he/she must be treated with care and respect stigmatization must be far away if we are to fight HIV.

Causes of stigmatization starts from the health facility, admission wards and ways you question your patients. Healthcare workers need not to be judgemental this can help patients to open up to you adding that once these barriers are removed HIV will reduce drastically. Dilating on confidentiality, he said it is the act of keeping and secure secret from others. Information given by or about an individual should never be let out even after the death of a patient except the patient wishes another party to know. The patient’s right charter needs to be respected. The patient has right to have sex, medication, social activities, right to education and to work, right to free healthcare, right to select facility for treatment, right to decision making, right to marriage and to give birth among others.

In creating key population friendly clinic, healthcare workers he said should receive training and sensitization on specific needs and challenges faced by key populations.

The clinics should have clear policies in place to ensure that all patients are treated with respect and without discrimination, ensure that privacy and confidentiality is respected at all times, establishing a referral network with other services, provide access to support services such as mental health counseling, social services and peer support groups and to have sensible clinic environment.

Dr. David Squire dilated on the role of healthcare workers in the uptake of HIV/ service of key populations, providing nonjudgmental care as this can create trust and respect for key populations, offering HIV education and prevention services, facilitating access to HIV testing and treatment, advocating for policy and legal changes, providing psychosocial support among others.

Fatmata Anne Karim, Complaint Desk Officer at Women In Crisis Movement gave an overview of key affected populations while Mr. Ahmed Bangura Field Officer at WICM talked on what support the healthcare workers can give key population clients.

Participants formed group of five to share how health workers can respond to a service users ie key populations. They all agreed that health workers need to adhere to acceptance, adherence to counseling, treatment, be polite, have a friendly environment, respect KPs’ opinions, good listening skills and that their approach to clients should be good.

Mr. Kamanda from Integrated Health Project Administration Unit (IHPAU) underscores that IHPAU is directly responsible through the Ministry of Health to supervise all implementing partners on all health related programmes sponsored by donors to the government of Sierra Leone.

Transport refunds formed part of the training.